Necrotizing Fasciitis (“Flesh-Eating Bacteria Disease”)

Necrotizing fasciitis is a very rare but severe complication of a bacterial infection of the skin or soft tissues. The word “necrotize” means causing tissue to die, and the “fascia” is the fibrous tissue that surrounds muscles, blood vessels and nerves. The media often refer to this condition as “flesh-eating bacteria” disease because the infection destroys skin, underlying tissue and adjacent muscles. Many different kinds of bacteria have been associated with this condition, but the most common germs are Streptococcus pyogenes (the same bacteria that causes strep throat), Staphylococcus aureus (the staph germ) and Clostridium (a germ that lives in the soil). Necrotizing fasciitis develops when the bacteria enter the tissues, often through a minor cut or scrape. The bacteria grow and release toxins or chemicals that destroy tissue and obstruct blood vessels, shutting off the flow of blood to the area and causing more damage. As the tissue dies, the bacteria can enter the bloodstream and course throughout the body. No one can predict when this condition will occur in reaction to a cut or scrape. However, it must be stressed that this is an extremely rare complication, especially when compared with the myriad of cuts and scrapes everyone experiences as part of normal activities. The usual slight redness and mild tenderness that accompany cuts and scrapes are not signs of this condition. Concern for this condition should occur when a small red and painful area on the skin changes to a very painful bruise-like area and grows rapidly, often in just a few hours. The pain may be severe and initially out-of-proportion to the appearance of the skin, which eventually becomes dark and may break open and ooze fluid. Other symptoms accompanying the skin changes can include:

• An overall ill feeling, generalized muscle soreness
• High fever, chills and sweating
• Nausea and vomiting
• Weakness or dizziness
• Acting incoherently

Necrotizing fasciitis is a medical and surgical emergency. Anyone experiencing an illness as described above should be taken immediately to a hospital emergency center for evaluation. The treatment requires a combination of strong antibiotics given intravenously and surgery to remove the destroyed tissue and drain the affected area. It is not unusual that the patient needs several operations over a period of days as the destruction of tissue can continue even after the treatment has been started. Occasionally, the tissue damage is so great that a limb has to be amputated. General first aid for cuts and scrapes, including a through cleansing of the area, is usually enough to avoid this difficult disease. You should contact your healthcare provider right away if a cut or scrape becomes complicated by rapid development of redness or swelling, drainage of pus or blood, severe pain or high fever.